Cerebral vasospasm after brain injury.

Severe vasospasm of the supraclinoidal portion of the internal carotid artery and the proximal part of the anterior and middle cerebral arteries was displayed by cerebral angiography in a 45 year old female patient who had developed progressive disturbance of consciousness and marked meningism with extremely bloody lumbar CSF within a few days after craniocerebral trauma. Aneurysm could be excluded angiographically and operatively. One and a half weeks after evacuation of a subdural haematoma and an intracerebral contusional bleeding, when the patient was discharged without any neurological deficit, control angiography showed that angiospasm had disappeared. The scanty literature on cerebral vasospasm after brain trauma is reviewed. The role of traumatic angiospasm in prognosis and the necessity for broad indications for cerebral angiography in cases with brain contusion is emphasized.